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Adverse drug reaction: any noxious unexpected, unintended, undesired or excessive response to a medication.

Drug-drug interactions: occur when two or more medications react with each other. This interaction may cause an unexpected side effect, e.g., Coumadin and aspirin given together resulting in bleeding; or additive effects, e.g., sedating antihistamine given with sedating antidepressant leading to sedation and falls.

Drug-disease interactions: undesired drug effects that occur in patients with certain disease states, e.g. antihistamines (with anticholinergic effects) given to patient with BPH causing acute urinary retention.


Drugs to avoid in Elderly

Atypical Presentation

Medications must be considered as the source for an abrupt change in condition. If any of the following symptoms develop, medications must be considered as an underlying etiology: abrupt change in mental status change, weight loss, dehydration, agitation or restlessness, anorexia, urinary retention, decline in functional status, or daytime sleepiness. Newly added medications are the usual culprit; however polypharmacy, drug-drug interactions, or drug-disease interactions must also be considered.

Assessment for High Risk Medications in the Elderly

Following are the most common medication classes that result in adverse drug reactions. Also listed are medications to avoid in the elderly as well as commonly prescribed medications.

Last updated - January 2005